Cancer killed her father yet still she smoked 60 a day

Princess Margaret spent almost her entire adult life taking the biggest risk of all with her health.

When she started smoking at 17, lighting up cigarettes in a tortoiseshell holder that was to become her trademark, no one fully understood their deadly legacy.

But within 20 years British doctors had proved that smoking kills. And the Princess only had to look to her own family's medical history to realise she was gambling with her health.

Four monarchs to whom she was related - Edward VII, George V, Edward VIII and her father George VI - died of smoking-related illnesses including heart and circulatory disorders. At least one in five stroke deaths is linked to smoking.

Yet the death of her heavysmoking father 50 years ago did not deter her from smoking up to 60 strong Chesterfield cigarettes a day for decades.

The addiction, which appeared to be as much to the glamour radiated by the habit in the Fifties and Sixties as to the nicotine, eventually led to the chronic ill-health that fatally undermined her zest for life in recent years.

She suffered repeated throat infections, laryngitis, flu, gastric illnesses, bronchitis and pneumonia - the clutch of respiratory problems that affect the weakened immune system of smokers.

In addition, she risked illness because of her famous enjoyment of whisky and gin - she was rarely seen without a drink or a cigarette in the heady days of her youth.

In 1978 she contracted a mild dose of hepatitis, inflammation of the liver, which led to her giving up drinking for a while.

The first major scare linked to her smoking came in 1985 when she complained of chest pains. There were fears she had lung cancer, the illness diagnosed in her father a year before his death.

However, after the removal of a piece of tissue which turned out to be non-malignant, the Princess carried on smoking for at least another eight years, despite repeated warnings from royal physicians and another bout of pneumonia in 1993.

But the odds were stacking up against her. Years of fast living and heavy smoking had doubled the likelihood of having a stroke and while on holiday in Mustique four years ago she suffered her first. It affected her left side and she had to be brought home by air ambulance.

Although she did not have any long-term paralysis, friends said she became tired more easily and her reaction times had slowed, which may have been a factor in the accident that accelerated her physical decline.

In March 1999 she scalded her feet in a bath while in Mustique, apparently due to a faulty thermostat, which left her in severe pain.

For the first time a frail-looking Margaret had to use a wheelchair in public while doctors grew increasingly concerned about the failure of her wounds to heal. She also suffered from depression, though it was never formally described as such.

Asked how she was feeling once, she said: 'I am so tired of the pain. It's such a bloody bore.'

She went on to undertake a few official engagements and visit her former beau, Roddy Llewellyn, and his wife in Oxfordshire.

But a senior Buckingham Palace figure says this left Margaret 'deeply depressed'. A stroke was immediately assumed to be the cause of two later episodes of illness.

In November 1999 she was taken ill at Kensington Palace but always denied it was a stroke.

Then she became ill again while spending Christmas 2000 with the rest of the royals at Sandringham.

Doctors later said she was still suffering after-effects from the first stroke, including severe loss of appetite that required hospital treatment.

But there was no denying the severity of her condition last March when another stroke paralysed her left arm and leg.

She also suffered serious loss of vision and her few public appearances since then, confined to a wheelchair with her face masked by sunglasses, shocked admirers.

Although stroke is not an inherited disease, there are genetic factors that can push up the risk including high blood pressure, f rom which the Princess is believed to have suffered.

Modern drugs have never been more effective at protecting high-risk individuals.

But doctors still believe that lifestyle holds the key to avoiding a stroke by stopping smoking, drinking in moderation, healthy eating and regular exercise.